Provider Demographics
NPI:1972807212
Name:LAKELAND HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:LAKELAND HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-327-5022
Mailing Address - Street 1:1150 HIGHWAY 59 LOOP N
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-9087
Mailing Address - Country:US
Mailing Address - Phone:936-327-5022
Mailing Address - Fax:936-327-5023
Practice Address - Street 1:1150 HIGHWAY 59 LOOP N
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9087
Practice Address - Country:US
Practice Address - Phone:936-327-5022
Practice Address - Fax:936-327-5023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care